| NPI | 1073587184 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: NC 98-01269) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: WV MS001) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2024-03-23 |